| NPI | 1912235235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK CHAVIS COO 804-355-1853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 1346-05-001) |
| Additional Taxonomies | 251E00000X Home Health (Licence: VA 1346-05-001) |
| Enumeration Date | 2009-11-24 |
| Last Update Date | 2009-11-24 |